The Broadway Company

NPI #1114062932 in Lewistown, Montana

Provider Information

NPI Number: 1114062932
Entity Type: Organization
Organization Name: The Broadway Company
Primary Specialty: Pharmacist
Enumeration Date: Feb 20, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 210 W MAIN ST
City: Lewistown
State: Montana
ZIP Code: 59457-2702
Phone: (406) 538-8128

Authorized Official

Name: MR. CHARLES WILLIAM WICKS, RPH
Title: PRESIDENT
Phone: (406) 538-8128

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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